Cabarrus hosts six steering committee meetings

Six of the NCACC's seven steering committees held meetings on Aug. 18 during the 104th Annual Conference in Cabarrus County. The Agriculture Steering Committee participated in a rolling workshop tour of Cabarrus County's Lomax Incubator Farm (see story).

Environment

The Environment Steering Committee heard a presentation from Evan Andrews, a regional engineer with Joyce Engineering, on landfill termination and post-closure care. He stressed the importance of counties assessing closed landfills and the rules and regulations applicable to post-closure care. The committee discussed different options available with regard to post-closure care of landfills.

NCACC Intern Latonia Strickland discussed the efforts she has undertaken to put the NCACC State of the Counties database into a GIS mapping program. She addressed some of the environmental indicators in the database and how GIS mapping will create a more effective tool for commissioners to analyze these indicators.

The committee also received information on a new state law that authorizes state-local partnerships for new water supplies. The N.C. Department of Environment and Natural Resources (DENR) provided the committee with a summary of the new law as well as the state resources available to local governments. The information provided by DENR is available online at www.ncacc.org/committees/env/h609-factsheet.pdf. Counties in need of additional information regarding these state-local partnerships for new water supplies should contact Tom Reeder, director of the Division of Water Resources, at (919) 715-3045 or tom.reeder@ncdenr.gov.

– Amy Bason

Health and Human Services

The Health and Human Services Steering Committee has been monitoring mental health restructuring over the past several years, with a particular focus on the statewide implementation of H916's capitated model of care, better known by its federal statutory reference as the 1915 (b)/(c) waiver. At its Aug. 18 meeting, DHHS Assistant Secretary Beth Melcher provided a progress report on statewide implementation efforts.

Melcher reviewed with the committee the goals of the waiver process – namely to improve access to services and the quality of care, to ensure that services are managed and delivered within a quality management framework based on medical necessity, to increase cost efficiency and help make Medicaid costs more predictable, and to generate appropriate financial incentives. Consumers and families can better shape the system through their choices of services and providers, while LMEs can build partnerships with consumers, providers and community stakeholders to create a more responsive system of community care.

How does it happen? The 1915 (b)/(c) waiver, building upon the successful Piedmont Behavorial Healthcare pilot, combines services for all Medicaid funded MH/DD/SA service recipients into a single capitated funding model, and enables the authorization for services to be managed locally. By setting aside the federal requirement to contract with "any willing and qualified provider," the local management entity (to be known as the MCO – managed care organization) can limit the provider network to the best and most responsive providers available. With new flexibility comes risk – the MCO assumes risk in managing services within the Medicaid capitation rate based on historical costs. These risks are not passed along to member counties of the LME/MCO – H916 clearly holds counties harmless from any cost overruns.

H916 also clearly encourages LME consolidation – the current number of LMEs (23) will be reduced to roughly eight to 12 to attain financial and management efficiencies and statewide consistency. Part of the consolidation is through a minimum LME population threshold – 300,000 by July 2012 and 500,000 by July 2013.

Through the request for applications process, Eastpointe (with The Beacon Center and Southeastern Regional), Pathways (with Mental Health Partners and Crossroads Behavioral Health), and Smoky Mountain Center have been selected to be the next LMEs to move forward with implementing the 1915 (b)/(c) Medicaid waiver. Through an earlier RFA process, the Western Highlands Network, Mecklenburg County, East Carolina Behavioral Health and the Sandhills Center were approved to move forward. Also approved was the expansion of PBH into Alamance-Caswell, Orange-Person-Chatham, and Five County.

The Durham Center – with Guilford, Johnston, and Cumberland counties – has been asked to submit a revised plan, and CenterPoint, Southeastern Center and Wake County have been asked to resubmit their RFA by Oct. 1 if they wish to remain in the RFA process.

In order to be successful, the LME/MCO must have appropriate technical skills, robust IT capacity, and organizational flexibility with regards to human resources and finance. The entity must understand the MCO role and how it differs from that of the traditional LME, must develop a strong provider network, and must ensure community and stakeholder involvement. All LMEs had to submit a waiver application by April 2011. Those LMEs not approved to manage 1915 (b)/(c) waiver by Jan. 1, 2013, will be merged or aligned with a waiver approved LME.

– Rebecca Troutman

Intergovernmental Relations

The Intergovernmental Relations Steering Committee received an update on federal and state transportation funding issues from Beau Memory, the N.C. Department of Transportation's legislative liaison. Memory told committee members that the state budget included additional funds for secondary road maintenance, but the funds were mostly targeted for bridge maintenance or replacement.

Memory also discussed federal transportation issues, describing the lack of movement on transportation authorization, but more importantly ongoing discussions at both the state and federal levels about repealing or capping the gas tax. Director of Government Relations Kevin Leonard told the committee that the Association had signed a coalition letter opposing capping the gas tax during the recent long session. The Association opposes the cap due to the impacts the decrease in funding would have on secondary road maintenance.

– Kevin Leonard

Justice and Public Safety

NCACC Legislative Counsel Amy Bason provided the Justice and Public Safety Steering Committee with an overview of H642 (the Justice Reinvestment Act of 2011), which makes significant changes to sentencing and corrections laws in North Carolina. The committee discussed particular aspects of the Justice Reinvestment Act that will directly impact counties.

The Act repeals the Criminal Justice Partnership Program (CJPP) and replaces it with the "Treatment for Effective Community Supervision Program." The Department of Correction will oversee this statewide program in lieu of individual county criminal justice partnership boards. DOC will be advised by a State Community Corrections Advisory Board that will have two county commissioner appointees.

In addition, the Justice Reinvestment Act establishes the Statewide Misdemeanant Confinement Program, which provides that misdemeanants sentenced to 91-180 days' confinement shall serve their sentences in county jails, but only in counties that volunteer to participate in the program. Eddie Caldwell, executive director of the N.C. Sheriffs' Association, spoke with the committee about the Sheriffs' Association's role in setting up certain details of the program, including reimbursement rates, transportation, jail capacity and any other related issues. The NCACC is working with the Sheriffs' Association to ensure that county concerns are addressed in this process.

– Amy Bason

Public Education

NCACC General Counsel Sharon Scudder reviewed the new charter school law for the Public Education Steering Committee. S8 ultimately passed with relatively simple changes – removing the charter school cap and requiring the State Board of Education to develop certain standards for charter schools.

Scudder described the torturous path the bill took through the legislative process, detailing how in versions passed by the House and Senate language was included to grant counties the ability to appropriate funding to charter schools for capital projects. These provisions were ultimately removed from the bill before it was passed.

Scudder also briefed the committee about the legal updates concerning pending cases related to Sugar Creek Charter School v. State of North Carolina, which specifically spoke to a county's authority to provide capital funding to charter schools. A recent decision in the case affirmed that counties do not have the authority or a requirement to fund capital projects for charter schools.

Committee members also discussed the Legislative Program Evaluation Division's report on community colleges and possible merger of smaller community college institutions. Jennifer Willis, director of government relations for the N.C. Community College System, briefed the committee on the report and also detailed reactions by her organization. In essence, the PED report makes two major recommendations: community colleges should take advantage of combined purchasing power; and smaller community colleges (less than 3,000 students) with larger colleges located nearby should merge.

According to the report, the merger recommendation would realize $5.1 million in savings due to consolidated administrative functions. The Community College System opposes the merger recommendation and has communicated with the Legislative Program Evaluation Oversight Committee as well as the Legislative Public Education Oversight Committee. After discussion, it was the recommendation of the steering committee to ask NCACC staff to continue to watch both the charter school capital funding issue and the community college merger issue and keep members updated on further developments.

– Kevin Leonard

Tax and Finance

The NCACC Tax and Finance Steering Committee, chaired by Gaston County Commissioner Joe Carpenter, wrapped up its 2010-11 work plan with a discussion on the role of counties in helping promote foreign exports of goods and services produced within a county. Several committee members had attended a similar session at the National Association of Counties' Annual Conference in Portland, Ore., and asked that NCACC organize a committee program to highlight North Carolina's efforts.

Greg Sizemore, director of the U.S. Department of Commerce's International Trade Administration's N.C. Export Assistance Center in Charlotte, provided an overview of his agency's services to connect businesses to the foreign export market. President Obama initiated the National Export Initiative (NEI) with a goal of doubling U.S. export values over five years. Less than 1 percent of U.S. companies export to foreign markets – and those that do mainly export to one market. The Export Assistance Centers can help connect businesses to prescreened customers.

North Carolina counties are assigned to one of three North Carolina Export Assistance Centers, which are located in Charlotte, Greensboro and Raleigh. Each focuses on small business exports through a joint venture with the U.S. Small Business Administration. The centers and SBA use 140 offices internationally, mostly through U.S. consulates, to provide small businesses with their "gold key" services, namely to qualified foreign buyers.

One of the most difficult challenges in foreign export is to ensure proper and timely payment. The centers and SBA have solved this issue by prescreening foreign buyers to identify those that not only have product interest but the financial wherewithal to complete the fiscal transaction.

The centers' services build upon an N.C. Department of Commerce initiative, "Passport to Exports," which helps secure a $5,000 SBA grant for businesses to increase foreign trade. For example, the grant funds may be used to translate business websites into foreign languages to entice prospective buyers or help finance an overseas trade mission trip to meet with qualified buyers. While this is a common practice internationally, U.S. businesses are just becoming involved in such measures.

Other services offered by the centers in cooperation with state commerce agencies include organizing consortia of like businesses to bundle shipping arrangements. For example, furniture produced by a number of local furniture makers was bundled together and shipped abroad to save on individual shipping costs.

The N.C. Department of Agriculture and Consumer Services' International Marketing Division also works closely with local, state and federal economic developers to internationally market North Carolina's agricultural products. Robert Hosford, an international trade specialist with the Division, provided to the committee an overview of his agency's services to connect North Carolina farmers with the foreign trade market.

Hosford lead off his remarks by emphasizing that agriculture remains the largest business in North Carolina, with military second and tourism third. Within the agricultural arena, North Carolina grows 90 percent of all tobacco produced in the United States, with 60 percent exported to China. Other top agricultural goods include wood products, pork, poultry and cotton.

As an example of relationship-building, Hosford's agency sponsors trade missions to connect market-ready companies with qualified buyers. Branding of North Carolina products is important to emphasize their quality and consistency of foreign markets — the "Got to Be N.C." campaign is an example of having consumers recognize foodstuffs and other agricultural products from North Carolina. The International Marketing Division organizes promotion by industry clusters. For example, a burgeoning middle class in Brazil is well-suited for the export of North Carolina-grown Christmas trees.

The NCACC Tax and Finance Committee plans to continue investigating the county role in enhancing foreign exports at future meetings and workshops.

– Rebecca Troutman